Revive Pharmacy Inc
Community/Retail Pharmacy
16205 S Tamiami Trl, Suite # 6, Fort Myers
Florida, 33908-5304
239-204-4223 239-204-4224
Revive Pharmacy Inc is a Community/Retail Pharmacy in Fort Myers, Florida. It is located at 16205 S Tamiami Trl, Suite # 6, Fort Myers and it's customer support contact number is 239-204-4223. The authorized person of Revive Pharmacy Inc is Nicole Deforte who is Owner of the pharmacy and his contact number is 239-204-4223. Active license number of Revive Pharmacy Inc is PH26342 for Community/Retail Pharmacy in Florida. Revive Pharmacy Inc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Revive Pharmacy Inc is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Revive Pharmacy Inc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Revive Pharmacy Inc |
| Type: | Community/Retail Pharmacy |
| Location: | 16205 S Tamiami Trl, Suite # 6, Fort Myers,
Florida, 33908-5304 |
| Phone: | 239-204-4223 |
| Fax: | 239-204-4224 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Nicole Deforte |
| Position: | Owner |
| Contact Number: | 239-204-4223 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1558610527 |
| NPI Enumeration Date: | 05 Sep, 2012 |
| NPI Last Update On: | 26 Feb, 2016 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Revive Pharmacy Inc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | PH26342 | Florida | Primary | |
| Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2136822 | Other | | Pk |
| 006790300 | Medicaid | Florida | |
Medicare Enrollment:
Revive Pharmacy Inc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 7810124484 | O20131206000487 | Revive Pharmacy Inc | PART B SUPPLIER - OTHER |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 16205 S Tamiami Trl, Suite # 6
Fort Myers, Florida |
| Zip: | 33908-5304 |
| Phone Number: | 239-204-4223 |
| Fax Number: | 239-204-4224 |
Patients can reach Revive Pharmacy Inc at
16205 S Tamiami Trl, Suite # 6, Fort Myers, Florida or can
call on customer care at 239-204-4223.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.